Headaches in kids

When you see teens today, it’s rare to find them not looking at a device or engaging with technology in some way. What you can’t see is how many of them have migraine. “Migraine is surprisingly common in kids and teens,” says Dr. Amy Gelfand, Director of the Pediatric Headache Program at UCSF Benioff Children’s Hospitals. “By age 10, migraine affects approximately 5% of children, meaning there’s a kid with migraine in nearly every classroom by 5th grade,” says Gelfand. The numbers are even more staggering for adolescents. “Some may not realize that the headaches they’re having are migraine,” says Gelfand, “as the diagnosis can be missed in teens.”

The key features for parents and doctors to focus on to determine if a child or teen has migraine are: During headaches, are they sensitive to lights or sounds? Do they experience nausea or vomiting? Do they want to lay down in a dark, quiet room? “During a migraine attack the brain is more sensitive to stimuli; lights seem brighter than they really are, smells and sounds can seem stronger than usual. This is why kids often want to just go lay down in a quiet room,” explains Gelfand.

While not dangerous, migraine can still be very serious. “Just because migraine isn’t life threatening, doesn’t mean it can’t severely affect a child or teenager’s life in a negative way. That’s why it’s so important to identify migraine early and treat it,” says Gelfand. Children with migraine miss more school than their peers and their school performance can be harshly impacted. “Imagine trying to take a math test while the page in front of you has become blurry and your head is spinning,” describes Gelfand.

The search for safe, effective migraine treatment options inspired Gelfand to study melatonin for migraine prevention in children and adolescents. Melatonin is a natural substance that the brain makes at night when it is dark. One of melatonin’s roles is to facilitate and improve sleep. Interestingly, taking a melatonin supplement every night has been shown to decrease migraine frequency in adults. Now Dr. Gelfand and her team are studying whether melatonin can also decrease migraine frequency in children and teenagers. “We are hoping to discover a well-tolerated, natural treatment for migraine in children,” says Gelfand, the lead investigator on the study.

The study is currently underway at UCSF Pediatric Headache Center and is recruiting 10-17 year-olds with migraine. “Our study design is exciting and innovative,” says Laura Dapkus, the research coordinator for the study. “Kids can complete most of the study from home using just their (or their parents’) smartphones. We wanted to make sure the study worked for busy families who don’t have time to be going back and forth to UCSF for study visits. We just ask people to come in one time—after that, they can do everything from home,” says Dapkus.